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Stress and adjustment reaction — Clinical Guidelines

Overview

Stress and adjustment reaction refers to psychological responses to identifiable psychosocial stressors, characterized by symptoms such as anxiety, depression, and maladaptive behaviors aimed at coping with distress 1 3 4.

Diagnosis

Symptoms include emotional exhaustion, cynicism, and reduced professional efficacy 1.

Physical status, emotional labor, and lack of social support are significant factors 1.

Elevated stress levels measured through psychological scales and biomarkers (e.g., cortisol, catecholamines) 4.

Resilience scores can help identify vulnerability to stress and burnout 3.

Management

Enhance social support systems and professional efficacy training 1.

Implement stress management programs including mindfulness and relaxation techniques 1 4.

Provide psychological counseling and support groups to address emotional exhaustion and cynicism 1.

Encourage regular physical activity to mitigate stress levels 4.

Special Populations

Pregnancy and Gynecology Nurses: Moderate to high levels of compassion fatigue noted, requiring tailored support interventions 1.

Trainees (Obstetrics and Gynaecology): Focus on resilience training and improved support structures to prevent burnout 3.

Elderly and Comorbidities: Limited specific data; general stress management approaches may be applicable but require individualized assessment 3 4.

Key Recommendations

Assess and address social support and professional efficacy to reduce compassion fatigue and improve job satisfaction (Evidence: Moderate 1).

Implement resilience training programs for high-stress roles like obstetrics and gynecology trainees to enhance coping mechanisms (Evidence: Moderate 3).

Integrate stress management interventions such as mindfulness and regular physical activity into work routines to mitigate mental and physical stress (Evidence: Moderate 4).

Provide psychological support services including counseling to address emotional exhaustion and cynicism among healthcare professionals (Evidence: Moderate 1).

Evaluate and enhance workplace support structures, particularly for roles with high emotional labor, to improve overall well-being (Evidence: Moderate 1 3).

References

1 Wang J, Su M, Chang W, Hu Y, Ma Y, Tang P et al.. Factors associated with compassion fatigue and compassion satisfaction in obstetrics and gynaecology nurses: A cross-sectional study. Nursing open 2023. link 2 Papworth A, Bedendo A, Taylor J, Beresford B, Mukherjee S, Fraser LK et al.. A new scale assessing the stressors and rewards of children's hospice work. BMC palliative care 2023. link 3 Ryder R, Kearney L, Kynn M, Weaver E. Resilience and workplace stress in Australian and New Zealand obstetrics and gynaecology trainees: A cross-sectional survey. The Australian & New Zealand journal of obstetrics & gynaecology 2020. link 4 Martinez de Tejada B, Jastrow N, Poncet A, Le Scouezec I, Irion O, Kayser B. Perceived and measured physical activity and mental stress levels in obstetricians. European journal of obstetrics, gynecology, and reproductive biology 2013. link 5 Kluger MT, Bryant J. Job satisfaction, stress and burnout in anaesthetic technicians in New Zealand. Anaesthesia and intensive care 2008. link 6 Rousseau AS, Hininger I, Palazzetti S, Faure H, Roussel AM, Margaritis I. Antioxidant vitamin status in high exposure to oxidative stress in competitive athletes. The British journal of nutrition 2004. link 7 Heyworth J, Whitley TW, Allison EJ, Revicki DA. Correlates of work-related stress among consultants and senior registrars in accident and emergency medicine. Archives of emergency medicine 1993. link 8 Garb R, Kutz I, Bleich A, Solomon Z. Varieties of combat stress reaction. An immunological metaphor. The British journal of psychiatry : the journal of mental science 1987. link

Stress and adjustment reaction